About the Center for Research on Health Care
The Center for Research on Health Care (CRHC) was created as a place where talented investigators can transform ideas into feasible projects, work together in multidisciplinary health services research teams, establish a broad-based research agenda, and train leaders and investigators in the conduct of health services research.
- Research Activities
- Educational Activities
- CRHC Services Provided to the Core Faculty
- Institutional Affiliations of the Core Faculty
The mission of the CRHC is to promote and conduct exemplary health services research.
The specific objectives of the CRHC include the following:
- To stimulate health services research by providing a collaborative center in which ideas can be transformed into feasible projects.
- To assemble interdisciplinary research teams to conduct large-scale studies in health services research.
- To maintain a broad-based health services research agenda.
- To train future leaders and investigators in health services research.
- To promote communication and collaborative relationships among departments and schools involved in health services research.
- Wishwa N. Kapoor, MD, MPH, Director
- Mark Roberts, MD, MPP, Co-Director
- Michael J. Fine, MD, MSc, Associate Director
- Doris M. Rubio, PhD, Data Center Director
- Lynn M. Rago, MBA, Administrator
The primary goal of the CRHC is to promote and conduct high-quality health services research. The center's success in this area is demonstrated by its continued ability to obtain funding from federal, state, foundation, and industry grants.
The number of faculty and staff working for the CRHC and the CRHC Data Center has grown considerably in recent years. This growth has helped us provide more investigators with feedback about their grant proposals and with state-of-the-art data management and analysis services for funded studies.
In 2008, the 62 core faculty members of the CRHC served as principal investigators or coprincipal investigators on 108 grants and received research funds exceeding $45 million. Moreover, during the past 4 years, the faculty published over 650 articles in peer-reviewed journals and presented their research results in hundreds of national and international conferences.
The CRHC has developed and expanded various initiatives to support its research efforts. It has a long-standing committee to review proposals for scientific merit prior to their submission to the Institutional Review Board (IRB) and external funding agencies. In the research review process, CRHC core faculty and their affiliates in the research community help investigators develop rigorous and methodologically sound research projects and also help them polish their grant proposals and research protocols. Over time, the CRHC review process has been refined to include delineated procedures for proposal preparation and review. The process is now well established and is cited as an example of excellence by research and IRB administrators of the University of Pittsburgh. Each year, the CRHC receives requests for review from researchers within and outside the CRHC, and it reviews between 50 and 75 proposals with the goal of improving their scientific quality and clarity.
The CRHC has fostered the development of several interest groups and working groups as a means to support the varied interests of the faculty, to promote collaborations and multidisciplinary research, and to provide a forum for the exchange of ideas and solutions to problems. The Data Management and Analysis Round Table Discussion Series, sponsored by the CRHC Data Center, is designed especially for individuals involved in systems analysis, programming, data management, and other fields related to data processing for research studies. The Clinical Systems Modeling Meetings provide a research forum in which attendees can become familiar with different applications of mathematical modeling and can draw on their own areas of expertise to address problems presented by speakers each month. The Patient-Provider Communication Interest Group includes individuals from a wide range of disciplines and focuses on communication issues concerning clinical care, research, and teaching. The Death and Loss Special Interest Group includes researchers, academicians, clinicians, and community care (hospice) providers. In addition to discussing issues related to chronic illness, advance planning, palliative care, death, and bereavement, this group focuses on family support and ethical considerations. Its meetings often include presentations of members' research, topics in the current literature, and reviews of members' publications. The group frequently is an incubator for research ideas and a source of peer review for grant proposals.
University of Pittsburgh Clinical and Translational Science Institute
The Clinical and Translational Science Institute (CTSI) serves as the integrative academic home for clinical and translational scientists across the University's six health sciences schools, Carnegie Mellon University, the University of Pittsburgh Medical Center (UPMC), and the region. The CTSI is directed by Steven Reis, MD, associate vice chancellor for clinical research in the health sciences. It is co-directed by Wishwa Kapoor, MD, MPH, director of the CRHC.
The institute's mission is to facilitate the translation of biomedical research advances into clinical and public health practice and policybridging from laboratory bench to patient bedside to community-based practice.
The CRHC faculty are extensively involved in the research activities and teaching activities of the CTSI, including the research training programs that are offered by the Institute for Clinical Research Education and are described below.
Center for Health Equity Research and Promotion
The CRHC has had a long-term interest in expanding health services research at the VA Pittsburgh Healthcare System. Its efforts in this regard have focused on recruiting faculty and staff for the VA Center for Health Equity Research and Promotion (CHERP). In 2001, the VA Health Services Research and Development (HSR&D) Service designated CHERP as a Center of Excellence in Health Services Research.
CHERP is led by Michael Fine, MD, MSc (principal investigator) and David Asch, MD, MBA (coprincipal investigator). The faculty of CHERP have broad expertise in quantitative and qualitative research methodologies, including psychometrics, database analysis, econometrics, technology assessment, and policy analysis.
CHERP's mission is to reduce disparities and promote equity and quality in health and health care among vulnerable groups of veterans and other populations. The center has four interrelated goals:
- To advance the science of health equity and health services research.
- To impact VA health care through effective dissemination and translation of research.
- To support and advance health equity and health services research training and mentoring within the Veterans Health Administration.
- To maintain and enhance the organizational infrastructure and intellectual environment to promote CHERP's mission.
The research agenda of CHERP is designed to advance our knowledge via three stages of investigation: the detection of disparities in health and health care; the identification of the reasons for these disparities (i.e., the identification and understanding of mechanisms and mediators); and the design and evaluation of interventions to promote equity in health and health care among vulnerable populations.
RANDUniversity of Pittsburgh Health Institute
The RAND Corporation is a nonprofit institution that helps improve policy and decision making through research and analysis. The RANDUniversity of Pittsburgh Health Institute (RUPHI) is a formal collaboration between RAND Health, a division of the RAND Corporation, and the University of Pittsburgh schools of the health sciences. The collaboration encompasses shared activities in research, education, and training, with a particular focus on creating and broadening synergies across a range of local institutions and addressing important local and national health care problems.
RUPHI is co-directed by Melony Sorbero, PhD, senior healthy policy analyst at the RAND Corporation, and Wishwa N. Kapoor, MD, MPH, director of the CRHC at the University of Pittsburgh.
The primary goal of RUPHI is to build an interdisciplinary health services research enterprise by:
- Expanding collaborative research opportunities in women's health through ongoing partnerships with Magee-Womens Research Institute (MWRI) and Magee-Womens Hospital of UPMC.
- Expanding collaborative research opportunities in behavioral health with investigators at the Western Psychiatric Institute and Clinic (WPIC) and the Community Care Behavioral Health Organization.
- Improving patient safety in collaboration with clinical scientists at the University of Pittsburgh Medical Center (UPMC).
- Translating new knowledge into evidence-based health care practice in collaboration with the University of Pittsburgh Clinical and Translational Science Institute (CTSI).
- Building a global health research program involving researchers across RAND Health, the University of Pittsburgh schools of the health sciences, and the Graduate School of Public and International Affairs.
At the heart of the RUPHI endeavor is the RUPHI Pilot Grant Program. This program has also allowed the institute to create and strengthen partnerships with a number of organizations within the University of Pittsburgh and to leverage funding for junior investigators who are collecting preliminary data to include in future grant applications. To date, RUPHI has made a total of 14 pilot grant awards, partnering with the MWRI, WPIC, and the CTSI.
The RANDUniversity of Pittsburgh Scholars Program is a unique 2-year postdoctoral fellowship program for individuals seeking to pursue careers in health services research or health policy. The program is sponsored by RUPHI, supported by the Agency for Healthcare Research and Quality, and housed jointly within the CRHC and RAND Health in Pittsburgh. The program has three main components:
- Education and Training. The University of Pittsburgh schools of the health sciences provide scholars with individualized didactic and experiential training. The program focuses on teaching methods in a comprehensive spectrum of health services research methodologies and on developing the leadership and professional skills necessary to excel as an independent health services researcher. Coursework includes basic skills training in health services research methods, health policy, computer methods, biostatistics, measurement, grant proposal development, medical writing, and ethics and regulation. Additional specialty track elective courses are also available. Depending on the number of courses completed, scholars receive a certificate or master of science degree from the University of Pittsburgh.
- Interdisciplinary Research Experience and Mentorship. Scholars are aligned with an ongoing RAND Health research project within or across the RAND Pittsburgh, Santa Monica, and Washington, DC, offices. This enables them to gain experience with a team of distinguished researchers from a variety of disciplines. The projects may be national, regional, or local in scope and involve various levels and types of stakeholders. Principal investigators on RAND projects serve as formal mentors to the scholars, with at least one local RAND mentor assigned to each scholar.
- Other Career Advancement Opportunities. Scholars have the opportunity to create a career development proposal or a collaborative RANDUniversity of Pittsburgh research proposal, either national or local in scope. Local research proposals may be prepared in partnership with one or more community organizations, including local health care providers, health plans, county health care departments and agencies, and social service organizations. In addition, the program is designed to help scholars produce professional conference abstracts and publish articles in peer-reviewed journals.
In the RANDUniversity of Pittsburgh Scholars Program, each scholar works with a multidisciplinary group of experienced faculty mentors from across RAND Health, the University of Pittsburgh, and affiliated research units on topics of health care delivery, health policy, patient safety, quality improvement, patient-centered care, health care organization and financing, or health care disparities.
The CRHC has a long-standing interest in training fellows and junior faculty in the planning and implementation of exemplary research.
In 1999, with funding from the Agency for Healthcare Research and Quality (formerly known as the Agency for Health Care Policy and Research), the CRHC developed the Training Program in Clinical Effectiveness/Evaluation Sciences. Under the direction of Mark S. Roberts, MD, MPP, this program was designed to provide rigorous but flexible training to enhance the conduct of health services research by offering an intensive summer program in biostatistics and quantitative methods in conjunction with other courses in cost-effectiveness analysis, decision analysis, quality improvement, large database analysis, and advanced biostatistics.
In 2000, through a K30 clinical research training grand awarded by the National Institutes of Health, the Degree-Granting Programs in Clinical Research were developed. These innovative programs brought together a multidisciplinary consortium that included many of the schools of the health sciences plus other departments and research centers dedicated to clinical and health services research.
The Certificate in Clinical Research Program and the Master of Science in Clinical Research Program teach the skills necessary to design and conduct high-quality clinical research involving human subjects, with the ultimate goal of increasing the number of clinical investigators at the University of Pittsburgh. A 10-credit core curriculum in clinical research provides a foundation in clinical research methods for a diverse group of trainees at all stages of the career pipeline, including medical students, graduate students, residents, fellows, and junior faculty.
Successful completion of the core curriculum in clinical research plus 5 elective credits leads to a certificate in clinical research. Successful completion of the core curriculum in clinical research, a year-long course in grant writing, and course requirements for one of the four specialty tracks (effectiveness, outcomes, and quality research; clinical trials research; health and behavior research; or translational research) leads to a master's degree in clinical research. In addition, students in the master's degree program may focus their elective coursework on optional content specializations, either in aging and chronic disease or in palliative care. Both degrees are granted through the School of Medicine.
In 2002, the CRHC developed similar programs in medical education. The Certificate in Medical Education Program is a 15-credit program designed for fellows and junior faculty members to enhance their skills as clinician educators, typically at either a university or community-based site. The Master of Science in Medical Education Program is a 30-credit program for fellows and faculty members who are pursuing careers in medical education and clinical teaching and who want intense training in clinical education.
Many CRHC faculty members serve as academic advisors for students in these programs, and experienced faculty researchers also serve as mentors for students who are pursuing a master's degree and developing research projects and proposals.
The CRHC has an outstanding record of mentoring and helping its students, trainees, and faculty to secure funding. Junior investigators have been funded within 13 years of recruitment. The CRHC is currently developing a formal mentoring program to educate mentors and mentees about their roles and responsibilities with respect to mentoring.
Health Services Research Seminar Series
In 1996, the CRHC created the Health Services Research (HSR) Seminar Series as a forum for researchers to discuss their work in progress, to plan methodology for new projects, and to refine presentations prior to national meetings. Seminars are held once a week.
In 2002 and 2003, CHERP and RAND became cosponsors of the series. Over the years, the HSR Seminar Series has evolved into a vehicle for the polished and professional presentation of results of completed research as well as the discussion of methodologic issues of interest to researchers in the Pittsburgh community. It has invited speakers from the University of Pittsburgh and Carnegie Mellon University, as well as speakers from the private sector and other research organizations and universities.
In 2008, for example, the speakers included researchers from the University of Pittsburgh, the University of California at San Francisco, the University of Wisconsin at Madison, Harvard University, the University of Pennsylvania, RAND Corporation, Duke University, and the Arabian Gulf University in Manama, Bahrain.
In addition to the general sessions and in recognition of evolving special interests of the CRHC's researchers over time, the seminar planners continue to identify specific foci for selected seminars. Examples of these foci include mental health, women's health, research and medical ethics, end-of-life care, aging, and health care disparities.
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Research Development Seminar Series
In 1999, to meet the needs of the junior faculty and staff, the CRHC developed the Research Development Seminar (RDS) Series.
The RDS Series is designed to provide a forum for young researchers to present their ideas and plans for research projects and obtain feedback from faculty and other experienced researchers. It is also designed to teach young researchers the fundamentals of grant proposal preparation, strategies to secure research funding, and methods to conduct excellent research.
In addition to focusing on faculty presentations of works in development, sessions have focused on the parts of a grant proposal, what goes on at a study section, creating effective PowerPoint presentations, data management in research, and how to respond to reviewers' comments.
The Sonis Lectureship, cosponsored by the CRHC and the Department of Health Policy and Management (formerly the Health Services Administration) of the Graduate School of Public Health, honors Anne C. Sonis as a loving wife, mother, and grandmother and lauds her personal interest in and professional commitment to the ideal of ensuring every citizen the right to compassionate, high-quality health care.
We are looking forward to the next Sonis Lecture to be held on September 29, 2015. The lecture will begin at noon in Lecture Room 6, Scaife Hall with a reception immediately following.
Diane E. Meier, MD, FACP
Director, Center to Advance Palliative Care
Co-Director, Patty and Jay Baker Palliative Care National Center
Catherine Gaisman Professor of Medical Ethics
Vice-Chair for Public Policy and Professor
Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai
New York, NY
Title: "Palliative Care Futurist: Matching Care to Our Patient’s Needs"
Dr. Diane E. Meier is Director of the Center to Advance Palliative Care (CAPC), a national organization devoted to increasing access to palliative care in the United States. Under her leadership the number of palliative care programs in U.S. hospitals has more than tripled in the last 10 years. She is also co-director of the Patty and Jay Baker National Palliative Care Center; Vice-Chair for Public Policy and Professor of Geriatrics and Palliative Medicine; Catherine Gaisman Professor of Medical Ethics; and was the founder and Director of the Hertzberg Palliative Care Institute from 1997-2011, all at the Icahn School of Medicine at Mount Sinai in New York City.
Presenters of the Sonis lectures have included the following:
- 2014, Lisa V. Rubenstein, MD, MSPH, FACP, Professor of Medicine and Public Health VA Great Los Angeles and UCLA, Director, Center for Implementation Practice and Research Support, Senior Scientist, RAND, Los Angeles, California. TOPIC: “Learning Organizations, Implementation Science and Quality Improvement: Health Services Research at the Crossroads.”
- 2013, John Ayanian, MD, MPP, Collegiate Professor of Internal Medicine, Professor of Health Management and Policy, Professor of Health Policy, Director, Institute for Healthcare Policy and Innovation, University if Michigan, Ann Arbor, Michigan. Topic: "Will Equity Be Achieved Through Health Care Reform?"
- 2012, Ashish Jha, MD, MPH, Associate Professor of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts. Topic: "The Affordable Care Act and the Broken U.S. Healthcare Delivery System: Strong Medicine or Placebo?
- 2011, Harold C. Sox, MD, Professor of Medicine, Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, New Hampshire, and Editor Emeritus, Annals of Internal Medicince. Topic: "Comparative Effectiveness Research: The Essentials."
- 2010, Elizabeth A. McGlynn, PhD, Associate Director, RAND Health, RAND Corporation, Santa Monica, California. Topic: "Tilting at Windmills: The Quest for Health Reform."
- 2009, Thomas Lee, MD, Network President, Partners HealthCare, Boston, Massachusetts. Topic: "Chaos and Organization in Healthcare."
- 2008, Karen Davis, PhD, President of The Commonwealth Fund, New York, New York. Topic: "Health Care: Solutions without Borders."
- 2007, Carolyn M. Clancy, MD, Director of the Agency for Healthcare and Research Quality, U.S. Department of Health and Human Services, Rockville, Maryland. Topic: "Making Tomorrow's Vision Today's Reality: Improving Patient Safety through Value-Based Health Care."
- 2006, Jonathan B. Perlin, MD, PhD, MSHA, FACP, Undersecretary for Health, Department of Veteran Affairs, Veterans Health Administration, Washington, DC. Topic: "Safe, Effective, Efficient, and Compassionate Health CareWithout the Need for an Advocate."
- 2005, Stephen M. Shortell, PhD, Dean, School of Public Health, and Blue Cross of California Distinguished Professor of Health Policy and Management, University of California, Berkeley. Topic: "What It Will Really Take to Improve Our Nation's Health System."
- 2003, Edward Wagner, MD, MPH, Director, W.A. MacColl Institute for Healthcare Innovation, and Professor of Public Health and Community Medicine, University of Washington, Seattle. Topic: "The Geology of the Quality Chasm."
- 2002, Wendy Levinson, MD, Professor of Medicine, University of Toronto, Ontario, Canada. Topic: "Money, Medicine, and the Physician-Patient Relationship."
- 2001, William M. Tierney, MD, Professor of Medicine and Chief of the Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, and Senior Research Scientist, Regenstrief Institute for Health Care, Indianapolis, Indiana. Topic: "Descent into Hell: Understanding Quality of Life in Cancer from the Researcher-Patient's Perspective."
- 2000, David W. Bates, MD, MSc, Professor of Medicine, Harvard Medical School, and Chief of the Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Topic: "Drug Safety: How Big a Problem? What Can Be Done?"
- 1999, Robert H. Brook, MD, ScD, Director, RAND Health Sciences Program, Santa Monica, California. Topic: "Quality of Health Care: Where Will It Be in the Next Century?"
- 1998, Stephen B. Soumerai, ScD, MSPH, Associate Professor of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts. Topic: "Improving Physicians' Clinical Decisions: Art or Science?"
- 1997, Troyen E. Brennan, MD, JD, Professor of Medicine, Law, and Public Health, Harvard Medical School and Harvard School of Public Health, Boston, Massachusetts. Topic: "Medical Injury, Malpractice Litigation, and the Cost of Health Care in the United States."
The CRHC provides the following services to members of its core faculty:
- Expertise in specific areas of health services researchvaluable for research development and collaboration.
- Senior experienced mentors for newly recruited junior faculty or faculty interested in changing career paths.
- Access to grant proposal writing support.
- Assistance in preparing budgets and budget justifications.
- Technical, administrative, and clerical help with research grant applications.
- Consultation on research design.
- Administrative assistance in hiring and managing research staff.
- Access to CRHC Data Center resources, including data entry, data management, and analytic support.
- Ability to keep current with health services research methodology and national and local research through the Health Services Research Seminar Series, which is sponsored by the CRHC, CHERP, and RAND.
- Opportunities to discuss new ideas for research and to present proposals for comments and feedback through the Research Development Seminar Series.
- The organized dissemination of information on funding opportunities from the Agency for Healthcare Research and Quality, the National Institutes of Health (NIH), the Veterans Health Administration, the Centers for Medicare and Medicaid Services, the Robert Wood Johnson Foundation, and other sources.
- Opportunities to improve skills in the preparation of grant proposals, medical publications, and oral presentations through the Research Development Seminar Series.
- Access to courses designed to increase methodologic expertise in diverse areas of health services research and thereby improve the quality of research and research proposals.
- Access to the CRHC grant proposal review process, which includes thoughtful and detailed feedback and suggestions from senior faculty members to grant writers before proposals are submitted to potential funding sources.
- Access to interest groups and working groups focusing on specific substantive areas to promote multidisciplinary collaboration, networking, and socialization.
- Access to the CRHC review of protocols for the Institutional Review Board and to CRHC help in revising protocols prior to submission.
- Timely dissemination of national and international research findings.
- Opportunities to meet and socialize with leaders in health services research.
The core faculty consists of individuals who are committed to the center's goals and have contributed substantially to its mission by mentoring young investigators, conducting collaborative research, or participating in formal educational activities developed for health services researchers. The core faculty members are a diverse group of talented researchers and educators representing the following:
- The School of Medicine, University of Pittsburgh
- Division of General Internal Medicine, Department of Medicine
- Department of Critical Care Medicine
- Department of Emergency Medicine
- Department of Neurological Surgery
- Department of Obstetrics, Gynecology, and Reproductive Sciences
- Department of Pediatrics
- Department of Psychiatry
- Division of Rheumatology and Clinical Immunology, Department of Medicine
- The Graduate School of Public Health, University of Pittsburgh
- Department of Behavioral and Community Health Sciences
- Department of Biostatistics
- Department of Health Policy and Management
- Center for Bioethics and Health Law, University of Pittsburgh
- The Katz Graduate School of Business, University of Pittsburgh
- Children's Hospital of Pittsburgh of UPMC
- Magee-Womens Hospital of UPMC
- VA Pittsburgh Healthcare System
- RAND Corporation
- H. John Heinz III School of Public Policy and Management, Carnegie Mellon University
- University of Pittsburgh Medical Center (UPMC)